The dental restoration of a partially or wholly edentulous patient with artificial dentition can be accomplished through several methods involving a dental implant. One common method has two stages. In the first stage, an incision is made through the gingiva to expose the underlying bone. An artificial tooth root, in the form of a dental implant, is placed in the jawbone for osseointegration. The dental implant generally includes a threaded bore to receive a retaining screw for holding mating components thereon. During the first stage, the gum tissue overlying the implant is sutured and heals as the osseointegration process continues.
Once the osseointegration process has sufficiently advanced, the second stage is initiated. Here, the gingival tissue is re-opened to expose an end of the dental implant. A healing component or healing abutment is fastened to the exposed end of the dental implant to allow the gingival tissue to heal therearound. The healing abutment is then removed and a prosthesis, which involves an abutment and artificial crown fitting over the abutment, is secured to the dental implant through the gingival aperture created by the healing abutment.
In an alternative method, the healing abutment can be placed on the dental implant immediately after the implant has been installed and before osseointegration. In this method, the osseointegration phase and gingival-healing step into a one-step process.
In a further alternative, the dental implant can be immediately loaded by use of a temporary prosthesis placed on the dental implant after it has been installed. In that situation, the gingival tissue heals around the temporary abutment.
Regardless of the method that is used, a primary goal is to have the soft tissue heal around the prosthesis in a predictable manner (i.e., similar to the patient's adjacent teeth) so that the prosthesis and soft tissue contours appear more natural. There are, however, many clinical factors that may impact the ability of the soft tissue to grow around and be preserved against the prosthesis, including at least the following (i) the patient's age, (ii) the patient's sex, (iii) the patient's race, (iv) the location of the implant-abutment interface relative to the bone, (v) the material of the abutment, (vi) the surface treatment on the abutment, (vii) the amount of surface area of the abutment exposed to the soft tissue, (viii) the soft-tissue displacement required when placing the prosthesis at the site after the second-phase soft-tissue healing process is complete, (ix) the type of bone at the implant installation, and (x) the patient's health conditions (e.g., smoker, diabetic, etc.).
Implant dentistry restorative methods have advanced to the digital world such that the scanning of the patient' mouth, of the impression of the patient's mouth, or the model of a patient's mouth provides the information needed for restoring the case. That information can be used to develop a patient-specific (i.e., custom) prosthesis for the patient. Some examples of the technology are discussed in U.S. Pat. Nos. 8,353,703, 8,257,083, 8,185,224, which are commonly owned and hereby incorporated by reference in their entireties. In these more modern digital dentistry systems, the creation of the design (the abutment and the crown to fit on the abutment) and the finalization of the design are generally accomplished by design technicians and dental laboratory personnel using CAD-CAM software. However, in the current systems, the designs are typically based on what the current patient requires based on his or her conditions. While the design technicians and dental laboratory personnel may rely on their experiences in designing other prostheses, the success of the soft-tissue outcome on the previously designed prostheses does not play a part in the current design.
A need exists for a patient-specific restorative system that leverages the knowledge of the soft-tissue outcomes of previous patients to develop a design for a prosthesis for a current patient. In doing so, the system provides a greater certainty that the predicted soft-tissue outcome for the current patient will become a reality for the current patient.